Implantable Device Employing Movement Sensing for Detecting Sleep-Related Disorders

• US 20110137197A1
• Filed: 02/15/2011
• Published: 06/09/2011
• Est. Priority Date: 09/18/2003
• Status: Active Grant

• Current Assignee: Jeffrey E. Stahmann, Jesse W. Hartley, Kent Lee, Quan Ni
• Original Assignee: Jeffrey E. Stahmann, Jesse W. Hartley, Kent Lee, Quan Ni
• Inventors: Stahmann, Jeffrey E., Hartley, Jesse W., Lee, Kent, Ni, Quan
• Granted Patent: US 8,657,756 B2
• Time in Patent Office: Days
• US Class Current: 600/546
• CPC Class Codes: A61B 5/4818 Sleep apnoea
• CPC Class Codes: A61M 16/0051 with alarm devices
• CPC Class Codes: A61M 16/024 including calculation means, e.g. using a processor
• CPC Class Codes: A61M 16/10 Preparation of respiratory gases or vapours
• CPC Class Codes: A61M 2205/3561 local, e.g. within room or hospital
• CPC Class Codes: A61M 2205/3584 using modem, internet or bluetooth
• CPC Class Codes: A61M 2230/04 Heartbeat characteristics, e.g. ECG, blood pressure modulation
• CPC Class Codes: A61M 2230/60 Muscle strain, i.e. measured on the user
• CPC Class Codes: A61M 2230/63 Motion, e.g. physical activity
• CPC Class Codes: A61M 2230/65 Impedance, e.g. conductivity, capacity
• CPC Class Codes: A61N 1/3601 of respiratory organs
• CPC Class Codes: A61N 1/3611 Respiration control stimulating respiratory organs A61N1/3601
• CPC Class Codes: A61N 1/36521 the parameter being derived from measurement of an electrical impedance
• CPC Class Codes: A61N 1/36542 controlled by body motion, e.g. acceleration

Abstract

Methods and systems for evaluating a pathological condition include acquiring movement information, such as electromyogram (EMG) information, and sleep disordered breathing (SDB) information, and detecting the presence of a pathological condition using both movement and SDB information. Methods may involve sensing physiological signals including at least muscle movement signals. Sleep-related disorders are detected using the sensed physiological signals, the sleep-related disorders including at least an involuntary muscle movement disorder and sleep-disordered breathing. Methods and systems also provide for detecting and treating a sleep-related disorder using movement and SDB information. Cardiac, respiratory, nerve stimulation, drug, or a combination of such therapies may be delivered to treat a detected or diagnosed pathological condition.

Claims

1. A medical system, comprising:

one or more movement sensors configured to sense movement of skeletal musculature, the one or more movement sensors including at least an electromyogram sensor;

a sleep-disordered breathing (SDB) sensor configured to sense a parameter associated with sleep-disordered breathing events; and

circuitry communicatively coupled to the one or more movement sensors and the SDB sensor, the circuitry configured to detect sleep-disordered breathing events based on the sensed parameter and to detect involuntary muscle movement events using signals produced by the one or more movement sensors, the circuitry configured to determine a composite sleep disorder index, the composite sleep disorder index quantifying combined effect of the involuntary muscle movement events and the sleep-disordered breathing events.

2. The system of claim 1, wherein a portion of the circuitry is disposed in an implantable housing.

3. The system of claim 1, wherein the circuitry is disposed in an implantable cardiac rhythm management system.

4. The system of claim 1, wherein the circuitry is disposed in a positive airway pressure device.

5. The system of claim 1, further comprising a sleep detector communicatively coupled to the circuitry.

6. The system of claim 1, wherein the sleep-disordered breathing events comprise one or more of sleep apnea, hypopnea, and Cheyne-Stokes respiration.

7. The system of claim 1, wherein the involuntary muscle movement events comprise one or more of bruxism, periodic limb movement disorder, and restless leg syndrome.

8. The system of claim 1, further comprising an implantable cardiac rhythm management system configured to deliver pacing therapy in response to the sleep disorder index.

9. The system of claim 1, further comprising a positive airway pressure device configured to deliver respiratory therapy in response to the sleep disorder index.

10. The system of claim 1, further comprising a drug delivery device configured to treat the involuntary muscle movement events.

11. The system of claim 1, further comprising a transcutaneous electric nerve stimulation therapy device configured to treat the involuntary muscle movement disorder.

12. A system, comprising:

a plurality of sensors configured to respectively sense a plurality of physiological signals including at least muscle movement signals comprising electromyogram signals;

a detector configure to detect sleep-related disorder events using the sensed physiological signals, the sleep-related disorder events comprising involuntary muscle movement events of non-respiratory muscles and sleep-disordered breathing events, the detection of the sleep-disordered breathing events and the involuntary muscle movement events based at least in part on the electromyogram signals; and

a processor configured to calculate a composite sleep disorder index, the composite sleep disorder index quantifying combined effect of the involuntary muscle movement events and the sleep-disordered breathing events, wherein at least one of calculating and detecting is implemented at least in part patient-internally.

13. The system of claim 12, further comprising communications circuitry configured to communicate one or both of the plurality of physiological signals and information associated with the detected sleep-related disorder events to a patient-external processing system.

14. The system of claim 12, further comprising communications circuitry configured to communicate one or more of the plurality of physiological signals, information associated with the detected sleep-related disorder events, and the composite sleep disorder index to an implantable medical device.

15. The system of claim 12, further comprising at least one of a controller configured to control therapy to treat a condition associated with one or more of the detected sleep-related disorder events based on the sleep movement disorder index and a therapy delivery unit configured to deliver the therapy to treat the condition associated with one or more of the detected sleep-related disorder events based on the composite sleep disorder index.

16. The system of claim 12, wherein the processor is configured to calculate the composite sleep disorder index including calculating an apnea/hypopnea index and a movement disorder index, the apnea/hypopnea index representative of an amount of apnea and hypopnea events relative to time and the movement disorder index representative of an amount of the involuntary muscle movement events relative to time.